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Other name: Durogesic/Mezolar/Matrifen Patch

What is it for?

Fentanyl is used for moderate to severe pain and to control on-going pain. It is not used for pain that only lasts a short time. You will be given a different, quick acting painkiller to take for breakthrough pain if you need to.

How do I take Fentanyl?

The medicine is inside a patch with a sticky back, which is stuck onto the skin. The painkiller, Fentanyl, slowly passes from the patch through the skin into the body. Each patch is only used once.

How long does a Fentanyl patch last?

Each patch lasts for three days. Change your patch(es) every third day at about the same time of day. Use a calendar to mark the day when you first start your patch(es) and when you change them. You should not stop using Fentanyl suddenly.

How do I change my patch(es)?

1. Take the old patch off, fold it in half, so that it sticks together and put it back in its original pouch. The used patch can then be put in the bin with your household rubbish.

2. Wash your hands. Choose a place on the upper body or upper arm. The skin should not have any cuts, scars or spots and should not be too hairy. Clean the skin with water only and make sure it is cool, and completely dry.

3. Tear open the pouch of the new patch. Peel the plastic backing off. Stick the patch onto the clean area of skin. Press it on firmly. Wash your hands. Do not stick the patch on the same place twice in a row.

What do I do if a patch falls off or I forget to change it?

Stick a new one on as soon as you can. If you are very late changing your patch, you may need to take another painkiller until the Fentanyl starts working again.

What should I do if I still get pain while using Fentanyl?

When you first start Fentanyl or the dose is increased, it takes time to work. Your doctor will give you extra painkillers to take if you need them until your patch is working completely.

Some people find that doing certain things like having a bath or going for a walk brings on pain. Your doctor may suggest you take a quick acting painkiller before you start doing something that brings on pain.

If your pain is not well controlled and you are needing to take more than 2-3 doses of extra painkiller a day, tell your doctor or palliative care nurse.

How will I know if Fentanyl is not going to work for some of my pain?

Although Fentanyl is a very good painkiller, it is not helpful for all types of pain. You may still have pain despite using bigger doses of Fentanyl and may feel unwell in one or more of these ways:

• more sleepy than usual

• feeling sick more of the time

• restlessness or jumpiness

• bad dreams

Do not worry if this happens. Tell your doctor or nurse. Your doctor may reduce your dose of Fentanyl and suggest other treatments to help the pain.

Are there any side effects from using Fentanyl?

Constipation

Fentanyl tends to cause less constipation than some other strong painkillers but you may still need to take a laxative regularly.

Sleepiness

This is uncommon but, if you become unusually sleepy or muddled, you may need the Fentanyl dose reduced. Contact your doctor or palliative care nurse.

Skin rash/irritation

If you develop itching or redness under the patch, tell your doctor or palliative care nurse.

Changing from another painkiller

A few people who change from another painkiller to Fentanyl feel unwell in the first 24-48 hours with sickness, shivering, stomach pains or diarrhoea. Contact your doctor if this happens.

Heat effects

The patches are waterproof, so you can have a shower or bath or go swimming. Avoid too much direct heat like a hot water bottle, electric blanket, heat lamp or hot spa bath, as this affects the way the medicine is released from the patch. If you develop a fever, try to keep your temperature down and contact your doctor.

Patch falls off frequently

Sweating or applying the patch to hairy skin may prevent it sticking well. You may be given some sticky tape to keep the patch on.

Can I drive?

Once you get used to using Fentanyl and do not feel sleepy or unwell, you may be able to drive. Please ask for a copy of the St Barnabas Patient Information Leaflet “Strong Painkillers and Driving”. You must discuss this with your doctor or palliative care nurse.

Can I drink alcohol?

A small glass of wine, beer or a sherry may help you feel better and improve your appetite. It is best to avoid taking more than this, as you may become too drowsy.

Reference

Lothian Palliative Care Guidelines January 2002